Active NPI
Jeffrey Charles Proctor, LPC
- Mental Health Counselor
- Richardson, TX
National Provider Identifier
1821688060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 84429
- Practice address
- 2007 N Collins Blvd Ste 301
Richardson, TX 75080-2666 - Phone
- (469) 930-0171
- NPI assigned
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 84429 | TX | Primary |
Addresses
Primary practice location
2007 N Collins Blvd Ste 301
Richardson, TX 75080-2666
Mailing address
433 Belle Grove Dr Unit 833251
Richardson, TX 75083-4658
Phone (940) 290-3191
Other practice location 1
550 S Watters Rd Ste 247
Allen, TX 75013-5230
Phone (940) 290-3191
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jeffrey@peaceharmonycounseling.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 28, 2024 through Mar 28, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84429 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1821688060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 BELLE GROVE DR UNIT 833251",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750834658",
"telephone_number": "940-290-3191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2007 N COLLINS BLVD STE 301",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750802666",
"telephone_number": "469-930-0171"
}
],
"practiceLocations": [
{
"address_1": "550 S Watters Rd Ste 247",
"address_purpose": "LOCATION",
"city": "Allen",
"state": "TX",
"postal_code": "750135230",
"country_code": "US",
"telephone_number": "940-290-3191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PROCTOR",
"first_name": "JEFFREY",
"middle_name": "CHARLES",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "84429",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jeffrey@peaceharmonycounseling.com",
"affiliation": "N",
"endpointDescription": "Email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "550 S Watters Rd Ste 247",
"city": "Allen",
"state": "TX",
"country_code": "US",
"postal_code": "750135230",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.